Finally laying to rest years of debate among fans, Silent Hill 2 art director Masahiro Ito has confirmed that Pyramid Head's design is not a creation of protagonist James Sunderland's mind but is instead an image from a painting brought to life. Silent Hill 2 players have long pondered whether the horrifyingly iconic appearance of Pyramid Head was from the mind of James or if it had a more complex origin, the latter of which has now been confirmed by the creature's creator.